Longitudinal assessment of urinary PCA3 for predicting prostate cancer grade reclassification in favorable-risk men during active surveillance.
Longitudinal assessment of urinary PCA3 for predicting prostate cancer grade reclassification in favorable-risk men during active surveillance.
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DOI：
10.1038/pcan.2017.16
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发表时间：
2017-09
影响因子：
4.8
通讯作者：
Pavlovich CP
中科院分区：
文献类型：
--
作者：
Tosoian JJ;Patel HD;Mamawala M;Landis P;Wolf S;Elliott DJ;Epstein JI;Carter HB;Ross AE;Sokoll LJ;Pavlovich CP
评估尿前列腺癌抗原3（PCA 3）作为男性主动监测（AS）的一次性和纵向指标的实用性。约翰霍普金斯AS项目通过系列PSA、直肠指检（DRE）、前列腺MRI和前列腺活检监测具有可排除风险的前列腺癌男性。自2007年以来，还定期采集DRE后尿液标本。纳入了在≥3年监测期间获得多个PCA 3测量值的男性。评估首次PCA 3评分（fPCA 3）、随后的PCA 3（sPCA 3）和PCA 3变化对随访期间Gleason分级重新分类（GR，Gleason评分>6）的预测作用。总共有260名男性符合研究标准。从入组到fPCA 3的中位时间为2年（IQR 1-3），从fPCA 3到sPCA 3的中位时间为5年（IQR 4-6）。在中位随访6年（IQR 5-8）期间，28名男性（11%）接受了GR。与无GR的男性相比，GR男性的中位fPCA 3（48.0 vs.24.5，p=0.007）和sPCA 3（63.5 vs.36.0，p=0.002）较高，而PCA 3的纵向变化并不因GR状态而异（对数归一化率0.07vs.0.06，p=0.53）。在包括年龄、风险分类和PSA密度的多变量模型中，fPCA 3与GR仍显著相关（log[fPCA 3]比值比=1.77，p=0.04）。接受GR的男性在AS期间获得的PCA 3评分较高，但PCA 3随时间的变化率并不因GR状态而异。PCA 3在包括传统危险因素的多变量模型中是GR的重要预测因子，表明PCA 3在AS背景下提供了增量预后信息。
To assess the utility of urinary prostate cancer antigen 3 (PCA3) as both a one-time and longitudinal measure in men on active surveillance (AS). The Johns Hopkins AS program monitors men with favorable-risk prostate cancer with serial PSA, digital rectal examination (DRE), prostate MRI, and prostate biopsy. Since 2007, post-DRE urinary specimens have also been routinely obtained. Men with multiple PCA3 measures obtained over ≥3 years of monitoring were included. Utility of first PCA3 score (fPCA3), subsequent PCA3 (sPCA3), and change in PCA3 were assessed for prediction of Gleason grade reclassification (GR, Gleason score>6) during follow-up. In total, 260 men met study criteria. Median time from enrollment to fPCA3 was 2 years (IQR 1–3) and from fPCA3 to sPCA3 was 5 years (IQR 4–6). During median follow-up of 6 years (IQR 5–8), 28 men (11%) underwent GR. Men with GR had higher median fPCA3 (48.0vs.24.5, p=0.007) and sPCA3 (63.5vs.36.0, p=0.002) than those without GR, while longitudinal change in PCA3 did not differ by GR status (log-normalized rate 0.07vs.0.06, p=0.53). In a multivariable model including age, risk-classification, and PSA density, fPCA3 remained significantly associated with GR (log[fPCA3] odds ratio=1.77, p=0.04). PCA3 scores obtained during AS were higher in men who underwent GR, but the rate of change in PCA3 over time did not differ by GR status. PCA3 was a significant predictor of GR in a multivariable model including conventional risk factors, suggesting that PCA3 provides incremental prognostic information in the AS setting.
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DOI：
10.1016/j.juro.2013.09.029
发表时间：
2014-03
期刊：
The Journal of urology
影响因子：
--
作者：
Patel HD;Feng Z;Landis P;Trock BJ;Epstein JI;Carter HB
通讯作者：
Carter HB
影响因子：
23.4
作者：
Ma, Ting Martin;Tosoian, Jeffrey J.;Carter, H. Ballentine
通讯作者：
Carter, H. Ballentine
影响因子：
2.1
作者：
Parekh, Dipen J.;Ankerst, Donna Pauler;Thompson, Ian M.
通讯作者：
Thompson, Ian M.
影响因子：
120.7
作者：
EPSTEIN, JI;WALSH, PC;BRENDLER, CB
通讯作者：
BRENDLER, CB
影响因子：
45.3
作者：
Wei, John T.;Feng, Ziding;Sanda, Martin G.
通讯作者：
Sanda, Martin G.